This invention relates to novel disclosing agents for use in the improvement of oral hygiene practices.
Dental plaque is a well-organized structure which forms on tooth surfaces and restorations. It consists mainly of bacteria surrounded by a matrix derived primarily from saliva and the bacteria themselves. Plaque differs from other soft tooth deposits such as material alba and food debris in that it has a definite architecture and cannot be flushed away by rinsing with water.
It is well established that dental plaque plays a major role in the etiology of periodontal diseases and caries. Although the exact manner in which plaque contributes to these disease states is not known at present, it is appreciated that effective and thorough removal of these deposits is absolutely essential for control program be established as part of the treatment plan for every dental patient. For this program to be effective the patient must be motivated to carry out thorough daily plaque control techniques. Motivation can be achieved, however, only by establishing goals that are meaningful and attainable by the patient. Experience has shown that most patients would not be sufficiently motivated to practice good oral hygiene if they were simply told that plaque is a bacterial colony growing on their teeth, and that plaque produces gingival disease and caries and must be removed daily. However, the entire concept of what plaque is and what it does to tissue can be made vital and important to the patient by visualization, whereby every patient is shown has plaque in situ and under the phase contrast of a microscope. The patient may also observe the diseased gingival areas and their juxtaposition to the places of plaque accumulations. These visual demonstrations serve two main purposes. First, it shows the patient that he does indeed have these dangerous bacterial deposits called plaque on his teeth. Secondly, in the microscopic visualization, he sees that those innocent looking masses are composed to millions of living bacteria of differing shapes. Experience has shown that the technique of visualization of plaque generates in patients a true interest in plaque and an obvious and apparent concern for its prompt removal.
Recent evidence has shown that plaque has a great destructive potential and, under varying conditions, can cause gingivitis and periodontitis, produce dental caries, or form into calculus. It has also been established that plaque accumulation which is allowed to develop without removal in many cases may cause gingivitis within one to twenty one days. There is also recent evidence indicating that plaque with all of its components may be capable of producing an allergic response in adjacent soft tissues.
This rather substantial potential destructiveness has given rise to the increased attention and the resultant recent attempts to educate the public in its control. Generally, this control has adopted an approach of oral lavage and focused on the tasks such as brushing, stimulating, massaging, rinsing spraying, and the like. However, while these techniques are effective for the removal of food debris and similar foreign matter, they are not very effective for removal of plaque. Plaque formation is transparent and is therefore not readily visible, particularly to one who is not skilled in its detection, and most often its removal occurs mainly by accident during oral lavage.
In order to increase the effectiveness of plaque detection and removal there has been a recent introduction into the marketplace of staining compositions or so-called disclosing compositions. these disclosing compositions contain coloring agents or dyes which are designed to be absorbed by the plaque to make the plaque visually distinguishable from the remainder of the oral cavity. The active staining ingredient in most of these commercially available disclosing compositions is generally iodine or several organic dyes which serve as the primary diagnostic agent.
Organic dyes have been almost universally adopted for use in the commercially available disclosing compositions because of their higher degree of effectiveness. However, in almost all of these cases these dyes have a highly unpalatable and objectionable taste which is not effectively masked by any known flavoring agent or sweetener.
In order to obviate the need of disclosing solutions as a diagnostic device, there has been a recent introduction in the marketplace of fluorescent light detection systems. These types of light detection systems rely upon compositions which are introducable into the oral cavity and contain an ingredient which is fluorescent when activated by a proper light source. It is contended that the fluorescent ingredient or dye is absorbable by the plaque and that the fluorescent dye will only fluoresce on the areas containing plaque formation when excited by this proper light source. However, in most cases the dye fluoresces at the same color as the enamel and, therefore, the plaque is not readily distinguishable. Furthermore, the purchase cost for these systems and the difficulty encountered in using these systems generally have militated against their widespread use.